p38MAPK/iNOS/HO-1信号通路在赤芍减轻大鼠内毒素性急性肺损伤中的作用

目的 评价p38MAPK/iNOS/HO-1信号通路在赤芍减轻大鼠内毒素性急性肺损伤(AL1)中的作用.方法 健康清洁级雄性Wistar大鼠40只,随机分为5组(n=8):生理盐水对照组(C组)、内毒素组(L组)、赤芍组(R组)、赤芍预处理组(PR组)和SB203580组(S组).气管内滴注脂多糖(LPS)制备大鼠ALI模型.L组气管内滴注1 ml LPS溶液(2.5 mg/kg);C组滴注等容量生理盐水;R组、PR组分别于气管内滴注LPS后、滴注前2 h,经股静脉输注赤芍注射液15 mg·kg-1·h-1 2 h;S组于气管内滴注LPS前3 h,经股静脉输注SB203580溶液2.5 μmol·kg-1·h-1 3 h.于气管内滴注LPS后6 h时,经颈动脉采血样2 ml,行血气分析及测定血清NO浓度;颈动脉放血处死大鼠,测定支气管肺泡灌洗液蛋白浓度,计数中性粒细胞及细胞总数,检测肺组织MDA含量,p38MAPK、HO-1及iNOS的表达.观察肺组织病理学结果 .结果 与C组比较,其余各组肺组织p38MAPK、iNOS及HO-1表达上调,支气管肺泡灌洗液中性粒细胞计数比、蛋白浓度、肺组织MDA含量及血清NO浓度升高.PaO2和HCO1浓度降低(P<0.01);与L组比较,R组、PR组和S组p38MAPK及iNOS表达下调,HO-1表达上调.支气管肺泡灌洗液中性粒细胞计数比、蛋白浓度、肺组织MDA含量及血清NO浓度降低,PaO2和HCO3-升高(P<0.05);R组、PR组和S组肺组织损伤程度较L组减轻.结论 赤芍可减轻大鼠内毒素性急性肺损伤,可能与抑制p38MAPK/iNOS/HO-1信号通路有关.     

p38MAPK信号转导通路在大鼠内毒素性急性肺损伤中的作用

目的 探讨p38丝裂原活化蛋白激酶(p38MAPK)信号转导通路在大鼠内毒素性急性肺损伤中的作用.方法 成年雄性SD大鼠60只,体重180～230 g,采用随机数字表法,将大鼠随机分为4组:对照组(C组,n=6)、急性肺损伤组(ALI组,n=24)、p38MAPK特异性抑制剂SB203580+ALI组(SB+ALI组,n=24)和SB203580组(SB组,n=6).ALI组尾静脉注射内毒素5 mg/kg制备大鼠急性肺损伤模型,C组给予等容量生理盐水,SB+ALI组于注射内毒素前30 min经尾静脉注射SB20358010 mg/kg.ALI组和SB+ALI组于注射内毒素后1、3、6 h(T1-3)时随机取8只大鼠,C组和SB组分别于给予生理盐水、SB203580后1 h处死取肺组织,检测磷酸化p38MAPK(p-p38MAPK)蛋白表达.T3时回收支气管肺泡灌洗液(BALF),测定蛋白浓度.计算细胞凋亡指数,观察肺组织病理学结果.另取32只大鼠,采用随机数字表法,将大鼠随机分为2组(n=16):ALI组和SB+ALI组,观察48 h内大鼠生存情况.结果 与C组相比,ALI组和SB+ALI组BALF中蛋白浓度、细胞凋亡指数、肺组织p-p38MAPK蛋白表达水平升高(P＜0.05);与ALI组相比,SB+ALI组上述指标降低(P＜0.05).SB+ALI组病理学损伤程度较ALI组明显减轻.ALI组大鼠生存率较SB+ALI组降低(P＜0.01).结论 p38MAPK信号转导通路参与了大鼠内毒素性急性肺损伤的发生和发展,可能与肺组织细胞凋亡有关.

Abstract：

Objective To investigate the role of p38 mitogen-activated protein kinase (MAPK) signal transduction pathway in lipopolysaccharide (LPS)-induced acute lung injury (ALI).Methods Sixty male SD rats weighing 180-230 g were randomly divided into 4 groups: control group (group C, n = 6), ALI group ( n = 24),p38MAPK specific inhibitor SB203580 + ALI group (group SB + ALI, n = 24), SB203580 group (group SB,n =6). LPS 5 mg/kg was injected intravenously via tail vein in group ALI and SB + ALI, while the equal volume of normal saline was given instead in group C. Group SB + ALI received iv injection of SB203580 10 mg/kg via tail vein 30 min before LPS administration. Group SB received injection of SB203580. The rats were sacrificed at 1, 3 and6 h agter LPS administration (T1-3) in group ALI and SB + ALI (8 rats at each time point) andat 1 h after administration in C and SB groups. The lungs were immediately removed for microscopic examination and determination of phosphorylated p38MAPK (p-p38MAPK) expression, the concentration of protein in bronchoalveolar lavage fluid (BALF) and apoptotic index (AI). Another 32 rats were selected and randomly divided into 2 groups for survival study: ALI group and SB + ALI group ( n = 16 each), and then they were treated as mentioned above and observed for 48 h. Results The concentration of protein in BALF, AI and p-p38MAPK expression were significantly increased in group ALI and SB + ALI compared with group C, while decreased in group SB + ALI compared with group ALI ( P ＜ 0. 05 ). LPS-induced pulmonary histological changes were significantly attenuated in group SB + ALI compared with group ALI. The survival rate was significantly decreased in group ALI compgred with group SB + ALI ( P ＜ 0.01 ). Conclusion p38 MAPK signal transduction pathway is involved in LPS-induced ALI, which may be related to the apoptosis in the cells in the lung.     

阿米洛利预先给药对大鼠内毒素性急性肺损伤的影响

目的 探讨阿米洛利预先给药对大鼠内毒素性急性肺损伤的影响.方法 清洁级雄性SD大鼠32只,体重200～250 g,随机分为4组(n=8):对照组(C组)、急性肺损伤组(ALI组)、阿米洛利组(A组)和阿米洛利预先给药组(AL组).C组股静脉输注生理盐水3 ml,ALI组股静脉输注生理盐水1 ml、内毒素6 mg/kg,A组股静脉输注阿米洛利10 mg/kg、生理盐水2 ml,AL组股静脉输注阿米洛利10 mg/kg、内毒素6 mg/kg,输注速率均为0.05 ml/rain,给药间隔均为30 min.于输注内毒素结束后6 h时处死大鼠取肺,观察肺组织病理学,并行病理学评分,称重后计算肺湿干重比,检测髓过氧化物酶(MPO)活性,测定支气管肺泡灌洗液总蛋白、TNF-α和巨噬细胞炎性蛋白-2(MIP-2)的浓度,采用Western blot法检测肺组织钠氢交换体1(NHE1)、p38丝裂原活化蛋白激酶(p38MAPK)和细胞外信号调节激酶(ERK)的表达水平.结果 与C组比较,ALI组和AL组肺组织病理学评分、肺湿干重比、MPO活性、支气管肺泡灌洗液总蛋白、TNF-α和MIP-2浓度、肺组织NHE1、p38MAPK和ERK的表达水平明显升高(P＜0.01),A组上述指标差异无统计学意义(P＞0.05);与ALI组比较,AL组肺组织病理学评分、肺湿干重比、MPO活性、支气管肺泡灌洗液总蛋白、TNF-α和MIP-2浓度、肺组织NHE1和ERK的表达水平明显降低(P＜0.01),p38MAPK表达差异无统计学意义(P＞0.05).结论 阿米洛利预先给药可减轻大鼠内毒素性急性肺损伤,其机制可能与抑制ERK信号转导通路激活有关.     

p38丝裂原活化蛋白激酶在全脑缺血再灌注损伤大鼠海马神经元DNA修复中的作用

目的 探讨p38丝裂原活化蛋白激酶(p38 MAPK)在全脑缺血再灌注损伤大鼠海马神经元DNA修复中的作用.方法 清洁级雄性SD大鼠108只,采用四血管阻断法建立大鼠全脑缺血再灌注模型,随机分为3组(n=36):假手术组(S组)仅暴露双侧颈总动脉和椎动脉;缺血再灌注组(IR组)侧脑室注射1%DMSO溶液5μl,30 min后行全脑缺血再灌注;p38 MAPK抑制剂SB203580干预组(SB组)侧脑室注射SB203580溶液5 μl(溶于1%DMSO溶液),30 min后行全脑缺血再灌注.分别于再灌注2、6、12、24、48和72 h时各组处死6只大鼠,提取海马组织观察神经元病理学结果,计算神经元凋亡指数(AI),测定磷酸化的p38 MAPK蛋白及Ku70蛋白表达水平.结果 与S组比较,IR组和SB组各时点AI升高,p-p38 MAPK蛋白表达上调,p-Ku70蛋白表达下调(P(0.05或0.01),病理损伤明显;与IR组比较,SB组各时点AI降低,p-p38 MAPK蛋白表达下调,p-Ku70蛋白表达上调(P<0.01),病理损伤程度减轻.结论 p38 MAPK可能通过下调DNA修复酶Ku70蛋白的表达,使海马神经元DNA修复功能受损,导致神经元凋亡,参与全脑缺血再灌注损伤.     

MLK3-MKK3/6-p38MAPK信号转导通路在大鼠内毒素性急性肺损伤中的作用

目的 探讨MLK3-MKK3/6-p38MAPK信号转导通路在大鼠内毒素性急性肺损伤中的作用.方法 健康成年雄性SD大鼠78只,体重200～250 g,随机分为4组:对照组(C组,n=6)、急性肺损伤组(ALI组,n=24)、MLK3抑制剂K252a组(MK组,n=24)和p38MAPK特异性抑制剂SB203580组(MS组,n=24).ALI组尾静脉注射内毒素5 mg/kg制备大鼠急性肺损伤模型,C组给予等容量生理盐水,MK组和MS组于注射内毒素前30 min经尾静脉分别注射K252a 75μg/kg、SB203580 10 mg/kg.ALI组、MK组和MS组于注射内毒素后1、3、6、12 h(1-4)时各组随机取6只大鼠,C组于给予生理盐水后即刻处死取肺,采用ELISA法测定支气管肺泡灌洗液中TNF-α浓度,称重后计算肺湿干重比,采用Western b1ot法测定p-MLK3、p-MKK3/6及p-p38MAPK的表达,观察肺组织病理学结果.结果 与C组比较,ALI组、MK组和MS组各时点支气管肺泡灌洗液中TNF-α浓度、肺湿干重比、p-MLK3、p-MKK3/6及p-p38MAPK的表达水平升高(P＜0.01);与ALI组比较,MK组上述指标降低,MS组支气管肺泡灌洗液中TNF-α浓度、肺湿干重比、p-p38MAPK表达水平降低(P＜0.05).病理学结果显示:MK组和MS组肺组织损伤较ALI组减轻.结论 MLK3-MKK3/6-p38MAPK信号转导通路在大鼠内毒素性急性肺损伤中起重要作用.     

p38MAPK信号转导通路在七氟烷后处理减轻乳鼠心肌细胞缺氧复氧损伤中的作用

目的 评价p38丝裂原活化蛋白激酶(p38MAPK)信号转导通路在七氟烷后处理减轻乳鼠心肌细胞缺氧复氧损伤中的作用.方法 健康新生SD大鼠,日龄1～3 d,处死后取心室肌组织,培养心肌细胞,随机分为7组:对照组(C组)于CO2培养箱中持续培养3 h;缺氧复氧组(AR组)细胞缺氧2 h,复氧1 h;七氟烷后处理组(SP组)细胞缺氧2 h,复氧开始即刻更换为3%七氟烷饱和的DMEM培养液,孵育20 min,再更换为无血清DMEM培养液,继续复氧40 min;七氟烷后处理+SB203580组(SP+SB组)于七氟烷后处理同时加入SB203580(p38MAPK特异性抑制剂)至5 μmol/L,孵育20 min;七氟烷后处理+二甲亚砜组(SP+DMSO组)于七氟烷后处理同时加入0.1%DMSO,孵育20 min;SB203580组(SB组)于复氧开始时加入SB203580至5 μmol/L,孵育20 min;二甲亚砜组(DMSO组)于复氧开始即刻加入0.1%DMSO,孵育20 min.各组细胞分别接种于24孔培养板(1 ml/孔)、35 mm培养皿(5 mlnd/皿)和50 ml培养瓶(8 ml/瓶)中,每组12孔、6皿和6瓶.于复氧结束后,采用比色法测定细胞培养液乳酸脱氢酶(LDH)活性;采用台盼蓝排斥实验测定细胞存活率;采用流式细胞仪测定细胞凋亡率;采用Western blot法测定磷酸化p38MAPK(p-p38MAPK)表达水平.结果 与C组比较,其余各组LDH活性升高,细胞存活率降低,细胞凋亡率升高,AR组、SP组、SP+SB组、SP+DMSO组和DMSO组p-p38MAPK表达上调(P<0.05);与AR组比较,SP组、SP+SB组和SP+DMSO组LDH活性降低,细胞存活率升高,细胞凋亡率降低,p-p38MAPK表达上调(P<0.05);与SP组比较,SP+SB组、SB组和DMSO组LDH活性升高,细胞存活率降低,细胞凋亡率升高,p-p38MAPK表达下调(P<0.05).结论 七氟烷后处理可通过激活p38MAPK信号转导通路减轻乳鼠心肌细胞缺氧复氧损伤.     

活化蛋白-1在大鼠内毒素性肺损伤时血红素加氧酶-1上调中的作用

目的 评价活化蛋白-1(AP-1)在大鼠内毒素性肺损伤时血红素加氧酶-1(HO-1)上调中的作用.方法 健康清洁级雄性SD大鼠48只,体重200 ～ 220 g,2.5 ～ 3.0月龄,采用随机数字表法,将其随机分为4组(n=12):正常对照组(C组)腹腔注射0.1％二甲基亚砜(姜黄素溶媒)0.5 ml,30 min时股静脉注射生理盐水(LPS溶媒)0.5 ml;内毒素性肺损伤组(ALI组)腹腔注射0.1％二甲基亚砜0.5ml,30 min时股静脉注射10 mg/kg LPS0.5 ml;姜黄素+内毒素性肺损伤组(Cur+ ALI组)腹腔注射20mg/kg姜黄素0.5 ml,30 min时股静脉注射10 mg/kg LPS 0.5 ml;姜黄素组(Cur组)腹腔注射姜黄素20mg/kg,30 min时股静脉注射生理盐水0.5 ml.静脉注射LPS 6 h时处死大鼠取肺组织,行病理学评分,测定MDA含量和SOD活性;采用Western blot法测定HO-1和AP-1表达;采用荧光定量PCR法测定HO-1 mRNA表达.结果 与C组比较,ALl组和Cur +ALI组肺组织病理学评分和MDA含量升高,SOD活性降低,HO-1 mRNA、HO-1和AP-1表达上调(P＜0.05),Cur组上述各指标差异无统计学意义(P＞0.05);与ALl组比较,Cur+ ALl组肺组织病理学评分和MDA含量升高,SOD活性降低,HO-1mRNA、HO-1和AP-1表达下调(P＜0.05).结论 内毒素性肺损伤时HO-1上调的机制与转录因子AP-1活化有一定关系.     

p38丝裂原活化蛋白激酶在罗哌卡因致SH-SY5Y细胞凋亡中的作用

目的 评价p38丝裂原活化蛋白激酶(p38MAPK)在罗哌卡因致SH-SY5Y细胞凋亡中的作用,以探讨罗哌卡因诱发神经毒性的机制.方法 采用随机数字表法,将SH-SY5Y细胞随机分为4组(n=18):正常对照组(C组)、10 μmol/L p38MAPK特异性抑制剂SB203580组(SB组)、3 mmol/L罗哌卡因组(R组)、10 μmol/L SB203580+3 mmol/L罗哌卡因组(SB+R组).C组在细胞培养液中继续培养；SB组在含10 μmol/L SB203580培养液中孵育；R组在含3 mmol/L罗哌卡因的培养液中孵育；SB+R组在含10 μmol/L SB203580的培养液中孵育30 min后,用含3mmol/L罗哌卡因的培养液继续孵育.各组细胞培养或罗哌卡因孵育4 h后采用流式细胞仪检测细胞内活性氧(ROS)水平和细胞凋亡率,采用Western blot法检测p38MAPK和磷酸化p38MAPK(p-p38MAPK)的表达,采用MTT法检测细胞活力.结果 与C组比较,R组和SB+R组ROS水平升高,p-p38MAPK表达上调,细胞活力降低,细胞凋亡率升高(P＜0.01),SB组上述指标差异无统计学意义(P＞0.05)；与R组比较,SB组p-p38MAPK表达下调,细胞活力升高,细胞凋亡率降低(P＜0.01).四组p38MAPK表达水平差异无统计学意义(P＞0.05).结论 罗哌卡因致SH-SY5Y细胞凋亡作用的机制部分与p38MAPK的激活有关.     

异丙酚对机械通气相关肺损伤大鼠肺组织p38MAPK信号通路的影响

目的 探讨异丙酚对机械通气相关肺损伤大鼠肺组织p38丝裂原活化蛋白激酶(p38MAPK)信号通路的影响.方法 雄性清洁级Wistar大鼠30只,体重230～300 g,2～3月龄,采用随机数字表法,将大鼠随机分为3组(n=10):对照组(C组)保留自主呼吸;机械通气组(V组)和异丙酚组(P组)行机械通气4h,P组在机械通气开始时静脉注射异丙酚5 mg/kg,机械通气期间以10mg·kg-1 ·h-1的速率静脉输注异丙酚.于机械通气15 min、1h、2h和4h时记录MAP,并采集股动脉血样,进行动脉血气分析,记录PaO2;机械通气结束时,测定支气管肺泡灌洗液(BALF)中总蛋白、TNF-α和巨噬细胞炎性蛋白-2(MIP-2)的浓度;取肺组织,测定湿干重比(W/D比)、MDA含量、SOD活性、细胞间粘附分子-1(ICAM-1)和p38MAPK、磷酸化p38MAPK(p-p38MAPK)蛋白的表达水平,计算p-p38MAPK/p38MAPK,并观察病理学结果,进行肺损伤评分.结果 与C组比较,V组和P组肺损伤评分、W/D比、肺组织MDA含量、ICAM-1表达、BALF中总蛋白浓度、TNF-α和MIP-2浓度和肺组织p-p38MAPK蛋白表达水平和p-p38MAPK/p38MAPK升高,V组肺组织SOD活性降低(P＜0.05),P组SOD活性差异无统计学意义(P＞0.05);与V组比较,P组肺损伤评分、W/D比、肺组织MDA含量、ICAM-1表达、BALF中总蛋白浓度、TNF-α和MIP-2浓度和肺组织p-p38MAPK蛋白表达和p-p38MAPK/p38MAPK降低,肺组织SOD活性、MAP和PaO2升高(P＜0.05).三组肺组织p38MAPK蛋白表达差异无统计学意义(P＞0.05).结论 异丙酚可能通过抑制p38MAPK信号转导通路的活化减轻大鼠机械通气相关肺损伤.     

P38MAPK信号通路在失血性休克复苏诱发急性肺损伤小鼠HO-1表达上调中的作用

目的 探讨p38分裂原激活蛋白激酶(p38MAPK)信号通路在失血性休克复苏诱发急性肺损伤小鼠血红素加氧酶1(HO-1)表达上调中的作用.方法 SPF级野生型小鼠C3H/HeN32只32只,10～12周龄,体重20～25 g,随机分为4组(n=8),假手术组(S组):只进行手术操作;失血性休克复苏组(HSR组):股动脉放血,至MAP为40 mm Hg,通过放血和回输血液维持MAP 35～45mmHg,60 min后回输全部血液和等失血量的乳酸钠林格氏液复苏;FR167653组(FR组):静脉注射p38MAPK抑制剂FR167653 5 mg/kg;FR+HSR组:于放血前30 min静脉注射FR167653 5 mg/kg.复苏后6 h处死小鼠,取肺组织,观察病理学结果,并进行病理学评分,计算肺湿/干重比,检测肺组织髓过氧化物酶(MPO)、IL-10、IL-6和HO-1水平以及p38MAPK的激活水平.结果 与S组比较,HSR组肺组织病理学评分、肺湿/干重比、MPO、IL-6、IL-10、HO-1和p38MAPK的激活水平升高,HSR+FR组肺组织病理学评分、肺湿/干重比和HO-1表达水平升高(P＜0.01),FR组上述指标差异无统计学意义(P＞0.05);与HSR组比较,HSR+FR组肺组织病理学评分、肺湿/干重比、MPO、IL-6、IL-10、HO-1和p38 MAPK激活水平降低(P＜0.01).结论 p38MAPK信号通路介导了失血性休克复苏诱发急性肺损伤小鼠HO-1的表达上调.     

Alveolar recruitment in acute lung injury

Alveolar recruitment is one of the primary goals of respiratorycare for acute lung injury. It is aimed at improving pulmonarygas exchange and, even more important, at protecting the lungsfrom ventilator-induced trauma. This review addresses the conceptof alveolar recruitment for lung protection in acute lung injury.It provides reasons for why atelectasis and atelectrauma shouldbe avoided; it analyses current and future approaches on howto achieve and preserve alveolar recruitment; and it discussesthe possibilities of detecting alveolar recruitment and derecruitment.The latter is of particular clinical relevance because interventionsaimed at lung recruitment are often undertaken without simultaneousverification of their effectiveness.     

Transimission of donor lymphocytes in clinical lung transplantation

Passenger mononuclear cells in organ grafts are known to influence the alloimmune response to the graft. To assess their relevance in clinical lung transplantation, we studied the amount, distribution, cell types, and surface marker expression of mononuclear cells in human donor lungs. Two major compartments of mononuclear cells could be differentiated: lymph nodes containing resting T and B lymphocytes, and the lung tissue itself, containing mainly activated lymphocytes as well as monocytes/macrophages. Tissue-associated mononuclear cells make up 20–40x10⁹ cells per lung, about 30–50 % of which are lymphocytes. Tissue-associated lymphocytes are predominantly T and NK cells; most of the T cells are CD8⁺ CD45R0⁺ and express HLA-DR. Strong expression of the adhesion molecules LFA-1 and ICAM-1 is present on infiltrating cells as well as on resident cells of the organ. Moreover, the lymphocytes inside the lung tissue are functionally highly active, with a strong stimulatory as well as alloreactive potency. Thus, large numbers of allogeneic mononuclear cells and particularly large numbers of functionally active lymphocytes are obviously transmitted by human lung allografts. The immunological in vivo relevance of these cells after lung transplantation may include allostimulation and graft-versus-host activity, but also beneficial immunomodulatory effects.     

单肺通气诱发肺损伤时兔肺组织线粒体转录因子A表达的变化

目的 探讨单肺通气诱发肺损伤时兔肺组织线粒体转录因子A(mtTFA)表达的变化.方法 健康雄性新西兰大白兔16只,体重2.5～3.0 kg,采用随机数字表法,将其分为2组(n=8)∶双肺通气组(TLV组)和单肺通气组(OLV组).气管切开插入自制双腔气管插管.TLV组双肺通气3h,OLV组左肺通气2h后再双肺通气1h.于通气开始即刻、通气1、2h、通气结束即刻采集动脉血样行血气分析,计算氧合指数.通气结束后开胸取左侧肺尖部组织,HE染色,光镜下观察病理学结果,行肺损伤评分,Western blot法检测肺组织mtTFA表达.结果 与TLV组比较,OLV组氧合指数降低,肺损伤评分升高,肺组织mtTFA表达下调(P＜0.05);OLV组肺组织病理学损伤程度严重.结论 单肺通气可能通过下调肺组织mtTFA表达诱发兔肺损伤.     

肺组织γ-氨基丁酸A型受体在大鼠内毒素诱发急性肺损伤中的作用

目的 探讨肺组织γ-氨基丁酸A型受体(GABAAR)在大鼠内毒素诱发急性肺损伤中的作用.方法 成年健康雄性Wistar大鼠32只,8周龄,体重200 ～ 230 g,采用随机数字表法,将其随机分为4组(n=8)∶正常对照组(C组)、内毒素组(LPS组)、γ-氨基丁酸预先给药+内毒素组(GABA组)和GABAAR拮抗剂荷包牡丹碱预先给药+内毒素组(BIC组).LPS组、GABA组和BIC组尾静脉注射LPS 5 mg/kg,C组给予等容量生理盐水;GABA组和BIC组分别于给予LPS前30 min时腹腔注射γ-氨基丁酸50 mg/kg和荷包牡丹碱10 μmol/kg.于给予LPS后6h时,采集动脉血样,测定PaO2,然后取肺组织,测定肺湿/干重比(W/D)、GABAAR表达、IL-6、TNF-α、MDA的含量和SOD活性,光镜下观察肺组织病理学结果.结果 与C组比较,LPS组、GABA组和BIC组PaO2降低,LPS组和GABA组肺组织W/D、TNF-α、IL-6和MDA的含量升高,肺组织GABAAR表达上调,肺组织SOD活性降低(P＜0.05);与LPS组比较,GABA组肺组织W/D、TNF-α、IL-6和MDA的含量升高,肺组织GABAAR表达上调,肺组织SOD活性降低(P＜0.05),而BIC组上述指标差异无统计学意义,GABA组和BIC组PaO2差异无统计学意义(P＞0.05).结论 肺组织GABAAR参与了大鼠内毒素诱发急性肺损伤的发展.     

微量肺源性内毒素对大鼠呼吸机相关性肺损伤的影响

目的 评价微量肺源性内毒素对大鼠呼吸机相关性肺损伤的影响.方法 成年雄性SD大鼠32只,体重370～390 g,随机分为4组(n=8):自主呼吸组(C组)、内毒素+自主呼吸组(LC组)、机械通气组(M组)和内毒素+机械通气组(LM组).LC组和LM组气管内滴入内毒素100 μg/kg;M组和LM组行机械通气,潮气量20 ml/kg,呼气末正压0,1:E 1:1,维持P_(ET)CO_235～45 mm Hg;C组和LC组保持自主呼吸.于机械通气前、机械通气1、2和3 h时行血气分析,并记录血液动力学指标.机械通气3 h时放血处死大鼠,测定肺组织病理学损伤评分、湿/干重比(W/D比)、支气管肺泡灌洗液(BALF)中白细胞计数和肺蛋白透性系数,采用ELISA法检测血浆TNF-α和巨噬细胞炎性蛋白-2(MIP-2)的浓度.C组和M组采用RT-PCR法测定肺组织CD14 mRNA的表达水平,免疫组化法测定BALF中CD14的表达水平.结果 C组和M组血浆中未检测到TNF-α;与C组比较,LC组肺组织病理学损伤评分、W/D比、BALF中自细胞计数、肺蛋白透性系数和血浆MIP-2浓度差异无统计学意义(P>0.05),血浆TNF-α浓度升高,M组肺组织病理学损伤评分、BALF中白细胞计数和血浆MIP-2浓度升高,LM组肺组织病理学损伤评分、W/D比和BALF中白细胞计数、肺蛋白透性系数、血浆MIP-2和TNF-α的浓度升高(P<0.05或0.01);与M组比较,LM组肺组织病理学损伤评分、W/D比、BALF中自细胞计数、肺蛋白透性系数、血浆MIP-2和TNF-α的浓度升高(P<0.05或0.01).与C组比较,M组BALF中CD14表达和肺组织CD14 mRNA表达上调(P相似文献   

Small dose of exogenous surfactant combined with partial liquid ventilation in experimental acute lung injury: effects on gas exchange, haemodynamics, lung mechanics, and lung pathology

A combination of exogenous surfactant and partial liquid ventilation(PLV) with perfluorocarbons should enhance gas exchange, improverespiratory mechanics and reduce tissue damage of the lung inacute lung injury (ALI). We used a small dose of exogenous surfactantwith and without PLV in an experimental model of ALI and studiedthe effects on gas exchange, haemodynamics, lung mechanics,and lung pathology. ALI was induced by repeated lavages (Pa_O2/FI_O2less than 13 kPa) in 24 anaesthesized, tracheotomized and mechanicallyventilated (FI_O2 1.0) juvenile pigs. They were treated randomlywith either a single intratracheal dose of surfactant (50 mgkg^–1, Curosurf^®, Serono AG, München, Germany)(SURF-group, n=8), a single intratracheal dose of surfactant(50 mg kg^–1, Curosurf^®) followed by PLV with 30 mlkg^–1 of perfluorocarbon (PF 5080, 3M, Germany) (SURF-PLV-group,n=8) or no further intervention (controls, n=8). Pulmonary gasexchange, respiratory mechanics, and haemodynamics were measuredhourly for a 6 h period. In the SURF-group, the intrapulmonaryright-to-left shunt (Q^·S/Q^·T) decreased significantlyfrom mean 51 (SEM 5)% after lavage to 12 (2)%, and Pa_O2 increasedsignificantly from 8.1 (0.7) to 61.2 (4.7) kPa compared withcontrols and compared with the SURF-PLV-group (P<0.05). Inthe SURF-PLV-group, Q^·S/Q^·T decreased significantlyfrom 54 (3)% after induction of ALI to 26 (3)% and Pa_O2 increasedsignificantly from 7.2 (0.5) to 30.8 (5.0) kPa compared withcontrols (P<0.05). Static compliance of the respiratory system(C_RS), significantly improved in the SURF-PLV-group comparedwith controls (P<0.05). Upon histological examination, theSURF-group revealed the lowest total injury score compared withcontrols and the SURF-PLV-group (P<0.05). We conclude thatin this experimental model of ALI, treatment with a small doseof exogenous surfactant improves pulmonary gas exchange andreduces the lung injury more effectively than the combined treatmentof a small dose of exogenous surfactant and PLV. Br J Anaesth 2001; 87: 593–601     

Lobectomy for cavitating lung abscess with haemoptysis: strategy for protecting the contralateral lung and also the non-involved lobe of the ipsilateral lung

We describe the anaesthetic management of a patient undergoinglobectomy for cavitating lung abscess complicated by haemoptysis.Surgery for lung abscess is one of the absolute indicationsfor the use of a double-lumen tube (DLT). Because pus or bloodcould impede fibreoptic- assisted DLT placement, a traditional,blind placement of the DLT was performed. To protect the uninvolvedparts of the operated lung, ventilation of the lung with theabscess was not performed until the resection of the involvedlobe had been completed. Br J Anaesth 2000; 85: 791–4 ^* Corresponding author